Bette Davis once said, “Old age is not for sissies.” There are many versions of her quote but they all express the sentiment that aging is a process that requires courage, endurance and fortitude.

We handle it best when we cope in the company of friends, family and community because, for many of us, aging may mean physical challenges, reduced income and a shrinking social circle. These factors, plus unrecognized depression, place some older adults—especially older men—at risk for suicide.

Suicide is a topic that’s unpleasant to think about and difficult to discuss. But research shows that talking about it is exactly what’s needed.

The Know the Signs campaign is California’s statewide program to help all of us learn how to recognize warning signs of suicide risk, find the words to speak to the people we care about, and reach out to available resources. The campaign’s website offers details on how to take these steps. (Editor’s note: This site is better viewed on a CDCR computer using a browser other than Internet Explorer 9, such as Chrome.).

The campaign is one of several statewide initiatives funded by counties through the voter-approved Mental Health Services Act (Proposition 63).  These efforts are administered by the California Mental Health Services Authority (CalMHSA) and are part of Each Mind Matters:  California’s Mental Health Movement.

Depression is often unrecognized in older adults, where it may appear as insomnia and other sleep disturbances, loss of appetite, or a lack of interest in the activities one once enjoyed. But depression is highly treatable with effective medications and therapies, and the treated person may find a renewed interest and joy in life.

Dr. Patrick Arbore, director of Elderly Suicide Prevention and Grief Related Services at the Institute on Aging, tells of meeting a woman at a nursing home who had previously been a volunteer at the same facility.

“When I asked her how she saw herself now at the age of 84, she replied, ‘I am nobody anymore. I used to be someone but I am no one now.’ As she continued to speak with me, it became clear that she was depressed. Fortunately, she agreed to a meeting with a psychiatrist who diagnosed depression. She began treatment with an antidepressant as well as meetings with a social worker. She utilized the Friendship Line, especially on weekends when she felt the loneliest. When I saw her a few months later, she was feeling much better. She said, ‘Being 84 wasn’t my problem; feeling lonely and depressed was.’”

Addressing other health and social problems can also make a huge difference in someone’s outlook.

“My great-aunt Lucy lived in a small town of 610 people,” said Anara Guard of the Know the Signs campaign. “When she turned 80, she lost interest in life. She stopped going to the senior center and didn’t want to cook any more. But then she saw her dentist who helped resolve an underlying problem with her teeth. Her entire attitude changed. She returned to the senior center and was elected president. More importantly, she enjoyed the rest of her time until she passed away at the age of 87.”

Of course, depression and other problems aren’t restricted by age. All of us face challenges as we age, whether in our 50s, 60s or 90s.

Learning to cope with retirement or job loss, a smaller budget, and those morning aches and pains are tasks for each of us. There are remedies available to everyone that become even more important as we grow older, including exercise, good nutrition, mindfulness and meditation, stress reduction, calming activities and cultivating an optimistic attitude. But when these aren’t enough, it’s good to know that further help is available.

The Friendship Line (800-971-0016) offers 24-hour support for people aged 60 years and older, and adults living with disabilities. Trained volunteers specialize in offering caring conversation with older adults.

Finally, if you’re concerned about a friend, relative or neighbor, don’t just stuff that worry away. Talk to your own parents or grandparents and ask direct questions. Bring up the topic of suicide overtly. Call the Friendship Line (800-971-0016), the National Suicide Prevention Lifeline (800-273-8255) or to talk to a trained counselor who can provide you with additional tips. Or visit